121371397-3-11-2020-13-CC-MAVS-BNFVEL-20200407162227

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 121371397
Report Date: 03/11/2020
Date Signed: 03/11/2020 03:12:42 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/23/2019 and conducted by Evaluator Jaime Snow

COMPLAINT CONTROL NUMBER: 13-CC-20191223152811

FACILITY NAME:	THOMAS, KAREN FAMILY CHILD CARE HOME		FACILITY NUMBER:	121371397
ADMINISTRATOR:	THOMAS, KAREN L.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 442-8052
CITY:	EUREKA	STATE: CA	ZIP CODE:	95501
CAPACITY:	14	CENSUS: 8	DATE:	03/11/2020
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Karen Thomas		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Child sustained unexplained injury while in care.

INVESTIGATION FINDINGS:

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On 3/11/20 at 1:45PM, Licensing Program Analyst (LPA) Snow conducted a follow up, unannounced, complaint inspection, and met with licensee, Karen Thomas. It was alleged that a child sustained an unexplained injury while in care; specifically, that an infant had a quarter sized bruise on the forehead and the facility staff did not know how it happened. The Licensee denied the allegation on 12/30/19 and again at 3:30pm on 3/5/20 stating that she did not think the bruise occurred at the facility. The licensee said she was shown the bruise when the child came in and had recalled that the infant had been within their sight or in their arms the previous day. The Licensee said the child showed no signs of injury while in care. Staff was interviewed and denied that the bruise happened at the facility stating that they observe this infant closely and that staff always tells the parents immediately about injuries even if they are slight.
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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Jaime Snow	TELEPHONE: (530) 215-6132
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 13-CC-20191223152811

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: THOMAS, KAREN FAMILY CHILD CARE HOME	FACILITY NUMBER: 121371397
	VISIT DATE: 03/11/2020

NARRATIVE

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The LPA spoke with the child’s guardian who described the bruise as “slight” and said it was hidden in the hairline and that she was not concerned because the staff is supervising when she has observed and because the infant is just learning to stand. At 2pm on 3/11/20 the LPA observed 9 children sleeping; the licensee was with two of them and staff was observing the other 7 children.
Three parents, two staff and four children were interviewed and did not corroborate the allegation of unexplained injuries or a lack of supervision. Child Records were received and reviewed, roster received.
Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, and the findings are unsubstantiated. An exit interview was conducted. The Notice of Site Visit must be posted for 30 days.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Jaime Snow	TELEPHONE: (530) 215-6132
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020

LIC9099 (FAS) - (06/04)

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